In the modern age, the use of prescribed medications to combat illnesses of all types is becoming increasingly complicated. This is due to many factors including the proliferation of medicines. In addition to multiple medications for well known and common diseases, there are now available and forthcoming medicines for a variety of ailments for which pharmaceutical therapy had not previously been available. The administration of these many pharmaceutical products is further complicated by the fact that often medications are used in combination to treat an illness. Therefore a patient is required to take multiple medications for a single condition.
This situation is still further complicated by the unfortunate circumstance that many patients are beset with multiple simultaneous health problems. Because there may be more than one medicine for each health issue, the patient can be forced to take a large number of different medications for periods of time. The Centers for Disease Control and Prevention currently reports that patient's over 65 typically are given 15 medical prescriptions per year and that 6 of these are for recurring prescriptions meant for continued administration of medications for the management of chronic conditions.
The amount and frequency of dosage are other problematic concerns. It is more the rule than the exception that each medication is prescribed to be taken at dosage levels and times different from others. Thus it becomes almost hopelessly difficult to track the correct schedule for taking multiple medications. This has been documented in an article titled: A systematic review of the associations between dose regimens and medication compliance [Claxton, A J; Cramer, J; Pierce, C Clin Ther. 2001 August; 23(8): 1296 310]. The review indicated that mean non-compliance across 76 studies in general was 29%, however, non-compliance increased to 49% among persons who took at least 4 medications. According to the Merck Manual of Medical Information/Home Edition, citing the Office of the United States Inspector General, noncompliance with drug treatment annually results in 125,000 deaths from cardiovascular disease, up to 23 percent of nursing home admissions, 10 percent of hospital admissions, many doctor visits, many diagnostic tests, and many unnecessary medical treatments. A study titled: Drug related medical emergencies in the elderly: role of adverse drug reactions and non compliance, [Malhotra, S; Karan, R S; Pandhi, P; Jain, S Postgrad Med J. 2001 November; 77(913): 703-7] asserts that 7.6% of all hospital admissions among the elderly were related to medication non-compliance. Perhaps the most well known example of this issue relates to the pharmaceutical therapy of Acquired Immune Deficiency Syndrome (AIDS). Some AIDS patients are prescribed to follow exacting regimens calling for the administration of at least three different medicine taken at different times around the clock for extended durations of therapy. The consequences of deviating from these regimens can be tragic.
Another factor that makes the use of modem prescription drugs difficult is the possibly adverse interaction between certain pharmaceutical products and allergic reactions to which some patients are susceptible. It is not uncommon for patients with multiple ailments to consult specialists for each health condition. Unless each doctor is aware of the medications that other physicians are simultaneously prescribing, the same patient can receive a prescription for a conflicting medicine. The medications themselves may have a cross reaction or a second medicine can have an aggravating effect on a different health condition for which the patient is currently being treated.
It is of course common to retain strong mental powers well into advanced age. However, memory loss among older persons is a general malaise. Considering that health problems tend to increase with age, it follows that the segment of population most likely to use pharmaceuticals is that which in general has intrinsic difficulty tracking the details of complex medical prescriptions.
For the reasons set forth above, there is a deeply felt need for a system that helps a user of pharmaceutical products be reminded to take the proper medicine at the proper time. Such a system which also has the ability to maintain and provide an up to the minute report of all prescribed medications, dosage amounts, dosage frequency and related precautions and instructions in connection with the administration thereof is very desirable.
Modem computer technology has several attributes that would seem to make it applicable to solving these problems. That is, present day computers can manage very large amounts of data and can make enormous numbers of calculations extremely fast. However it has not been until extremely recently that computer technology having the capability to deliver real-time customized reminders to individual patients with respect to medical prescriptions has even been contemplated.
Thus there is a continuing need for a system and method that can track diverse medications, their amounts and administration regimens for a large number of people and to deliver instantaneously, real-time and/or batch-based, customized reminders addressed to specific individuals to take their medicines. It is also desirable to provide a prescription reminding system that functions without the need for loading of information or reminder schedule programming by the patient.
Efforts by many health institutions to use telephone calls to remind patients throughout the day to take prescribed medications are often found to be intrusive and have been met with limited success. The well-designed study titled The effects of postal and telephone reminders on compliance with pravastatin therapy in a national registry: results of the first myocardial infarction risk reduction program [Guthrie, R M. Clin Ther. 2001 June; 23(6): 970-80] indicated that telephone reminders did not improve compliance. These studies have also been extended to the utilization of cell phones. While the success factors are still being studied, it is expected that improved compliance will be negatively influenced by the facts (a) that many senior patients do not routinely carry a cell phone, and (b) that those who have a cell phone frequently leave the phone turned off. There is thus also need for a prescription reminding service that can successfully improve compliance without causing the patients to significantly change behavior, e.g. by buying and using cell phones.